Veterans’ Experiences with Combat-Related PTSD Treatment

The purpose of this study was to explore from Veterans’ perspectives, their experiences with combat-related post traumatic stress disorder (PTSD) treatment and to report their advice to social workers involved in treating Veterans. This subject has particular importance given the increasing number of Veterans who have returned and are currently returning from deployments in Iraq and Afghanistan with this diagnosis. Interviews were conducted with four subjects, all of whom had been deployed to a combat zone, were diagnosed with combat-related PTSD, and completed outpatient treatment prior to July 1, 2012. The interviewees discussed their experiences with PTSD treatment and offered advice to social workers who treat Veterans with combat-related PTSD. Two Veterans experienced more re-experiencing symptoms, such as dreams, after treatment. Avoidance symptoms among the Veterans in this study included avoiding treatment, avoiding people, and avoiding military duty. The findings confirmed that arousal symptoms, specifically irritability, are often triggered by common daily events, such as a camera flash, a tractor backfiring, or a neighbor’s knock on the front door. All participating Veterans reported that their treatment was positively affected by family or friend-based support systems. The implications for social workers include providing liaison-type services between doctors and Veterans and engaging and supporting family members in the treatment and recovery process. Additionally, the Veterans in this study implied an importance to the social worker having shared experiences with the Veteran

Veterans’ Experiences with Combat-Related PTSD Treatment

The purpose of this study was to explore from Veterans’ perspectives, their experiences with combat-related post traumatic stress disorder (PTSD) treatment and to report their advice to social workers involved in treating Veterans. This subject has particular importance given the increasing number of Veterans who have returned and are currently returning from deployments in Iraq and Afghanistan with this diagnosis. Interviews were conducted with four subjects, all of whom had been deployed to a combat zone, were diagnosed with combat-related PTSD, and completed outpatient treatment prior to July 1, 2012. The interviewees discussed their experiences with PTSD treatment and offered advice to social workers who treat Veterans with combat-related PTSD. Two Veterans experienced more re-experiencing symptoms, such as dreams, after treatment. Avoidance symptoms among the Veterans in this study included avoiding treatment, avoiding people, and avoiding military duty. The findings confirmed that arousal symptoms, specifically irritability, are often triggered by common daily events, such as a camera flash, a tractor backfiring, or a neighbor’s knock on the front door. All participating Veterans reported that their treatment was positively affected by family or friend-based support systems. The implications for social workers include providing liaison-type services between doctors and Veterans and engaging and supporting family members in the treatment and recovery process. Additionally, the Veterans in this study implied an importance to the social worker having shared experiences with the Veteran

Military Resilience and Transformation: A Narrative Inquiry Highlighting the Challenges Faced by Military Veterans of the Wars in Iraq and Afghanistan During Their Transition from Combat to Civil Society

This research examines major transitions in military life experienced by veterans of the recent wars in Afghanistan and Iraq. These transitions include reintegration challenges that deployed military members encounter as they blend back into family, community, church and a peacetime setting, from the war-zone to a civilian career and lifestyle. While most military personnel are resilient and have the ability to recover from the difficult circumstances associated with combat, such as experiences and exposure to traumatic situations, many experience problems handling stress over the months or years of transitioning from a war-zone to civil society. The research focused on: the impact that these transitions had on the military members returning from combat, and on their families and communities; the level of involvement these groups face during the transition phase; and the interest in making the transition better for everyone. The following research questions guided this study: “What are the most significant challenges faced by military service members when they return from combat in Iraq and Afghanistan? What were their transformative experiences? What common factors apply to resilience and transformational learning? What are the most important resources that contribute to the transformational process of the military service member? What external support has been most helpful during the transformational process?” This study incorporates a theoretical framework introduced and developed by Jack Mezirow over a period of years that has become known as Transformative Learning Theory (1978, 1981, 1990a, 1991, 2000). It is considered the “most researched and discussed theory in the field of adult education” (Taylor, 2007, p. 173). Mezirow’s theory addresses the issue of how and why personal experiences, specifically crises, change the way people view, understand and participate in their world. In addition to transformational learning theory, this study also focused on the resiliency theory, which is defined as “the capacity to rebound from adversity, misfortune, trauma, or other transitional crises, strengthened and more resourceful” (Seccombe, 2002, p. 384). The methodology used in this qualitative study was a narrative ethnographic approach. Narrative inquiry involves entering into lives of each participant. This form of qualitative research focuses on a search for common themes across the participants’ stories and uses the participants’ stories to develop and confirm existing conceptual systems. Several sources of data were used in addition to stories shared by the participants, such as various types of media, observations, my personal experiences, creative expression, and my field notes. Four major themes emerged from the data analysis process: Theme one - The Fight Response; Theme two - Readapting to the New Culture of Civilian Life; Theme three - Rebuilding a New Support System Outside of the Military; and Theme four - Finding Meaning, Perspective and Purpose in a New Life. The combined analysis of all sources of data supported the fact that in most cases the veterans returning from combat in Iraq and Afghanistan experienced various levels of difficulty during the transition to civil society. In the process of these transitions, the veterans experienced some form of transformational learning, which can be applied for future research, analysis, and study

THRIVING THROUGH THE CRACKS: PROMOTING MENTAL HEALTH RESILIENCE IN THE U.S. BORDER PATROL

The U.S. Border Patrol has become the face of immigration in the United States because of the wave of migrants at the southern border who continue to seek the American dream by extreme means. While the literature is replete with accounts of immigrants and their treacherous journeys, this thesis tells a different, yet equally relevant, story—that of the Border Patrol agent whose professional and personal life is challenged every day by such stressors as the threat of violence and danger, political pressures, and moral injury. This thesis seeks to identify alternative programs for building mental-health resilience as suicides among Border Patrol agents remain constant. To this end, this thesis explores mental health challenges and their causes and the barriers to seeking treatment that are unique to law enforcement and the Border Patrol. As the migrant crisis continues, it is essential that Border Patrol agents be provided with the necessary tools to maintain their resilience while protecting America. This thesis conducts a comparative case study to analyze two programs that the U.S. military utilizes (equine assistance therapy and the battle buddy system). This thesis finds that both programs benefit overall mental wellness and thus recommends that the U.S. Border Patrol consider implementing the two programs into its current resiliency plan.Civilian, Department of Homeland SecurityApproved for public release. Distribution is unlimited

Ways of Being in Trauma-Based Society: Discovering the Politics and Moral Culture of the Trauma Industry Through Hermeneutic Interpretation of Evidence-Supported PTSD Treatment Manuals

One hundred percent of evidence-supported psychotherapy treatments for trauma related disorders involve the therapist learning from and retaining fidelity to a treatment manual. Through a hermeneutic qualitative textual interpretation of three widely utilized evidence-supported trauma treatment manuals, I identified themes that suggested a particular constitution of the contemporary way of being—a traumatized self—and how this traumatized self comes to light through psychotherapeutic practice as described by the manuals. The manuals included: 1) a trauma focused cognitive-behavioral therapy for children; 2) an eye-movement desensitization and reprocessing therapy for adults; and, 3) an early intervention and debriefing therapy series for post-traumatic stress disorder and other trauma related problems of military service members. Through the interpretation, I conceptualized trauma as a way of human being in contemporary culture, and in particular, as an unacknowledged way of expressing enactments of dissociated, unformulated, or unarticulated political arrangements and events. I identified and interpreted the following shared themes and exemplars across the three manuals: mind-brain as protector and the political use of cognitivist ideology; the healed trauma survivor as functional worker; trauma as universal and culture-free; and, indoctrination into a social void of scientistic managed care. I discussed how trauma treatment manuals instantiate how to be human in contemporary society through compliance with managed care and the embodiment of scientistic and cognitivist ideology. I then discussed how the way of being that contemporary society creates and idealizes is one in which people easily assume the identity of trauma survivor: an enterprising, functional and fiercely individual member of a warrior cult. In the warrior cult society, to think or talk about social causes and public solutions to daily political suffering is thought of as either non-germane or dangerous; individuals are seen as free from all dependencies and social ties, able to overcome personal and public adversity by arming or forifying their brain and replacing thoughts in their computer-like mind. In conclusion, I raised questions about how evidence-based trauma therapies may contribute to perpetuating a particular constitution of self that has disavowed society’s violent ethics and practice

Post Traumatic Stress Disorders in a Global Context

If, as a health care or social service provider, one was called upon to help someone who has experienced terror in the hands of a hostage taker, an irate and chronically abusive spouse or parent, or a has survived a motor vehicle accident, landslide, earthquake, hurricane or even a massive flood, what would be one's priority response? What would be considered as the most pressing need of the individual requiring care? Whatever the answer to each of these questions, people who have experienced terror, suffer considerable psychological injury. Post-Traumatic Stress Disorder in a Global Context offers some answers to meet the needs of health care and socials service providers in all settings, whether in a hospital emergency room, at the war front, or natural disaster site. The take home message is, after providing emergency care, there is always a pressing need to provide mental health care to all victims of traumatic stress

Internet-based cognitive and behavioural therapies for posttraumatic stress disorder (PTSD) in adults

Therapist-delivered trauma-focused psychological therapies are an effective treatment for post-traumatic stress disorder (PTSD). These have become the accepted first-line treatments for the disorder. Despite the established evidence-base for these therapies, they are not always widely available or accessible.Many barriers limit treatment uptake, such as the limited number of qualified therapists to deliver the interventions, cost, and compliance issues, such as time off work, childcare, and transportation, associated with the need to attend weekly appointments. Delivering cognitive behavioural therapy (CBT) on the Internet is an effective and acceptable alternative to therapist-delivered treatments for anxiety and depression. However, fewer Internet-based therapies have been developed and evaluated for PTSD, and uncertainty surrounds the efficacy of Internet-based cognitive and behavioural therapy (I-C/BT) for PTSD. Objectives To assess the effects of I-C/BT for PTSD in adults. Search methods We searched the Cochrane Common Mental Disorders Group's Specialised Register (CCMDCTR) to June 2016 and identified four studies meeting the inclusion criteria. The CCMDCTR includes relevant randomised controlled trials (RCT) from MEDLINE, Embase, and PsycINFO.We also searched online clinical trial registries and reference lists of included studies, and contacted researchers in the field to identify additional and ongoing studies. We ran an update search on 1 March 2018, and identified four additional completed studies, which we added to the analyses along with two that were previously awaiting classification. Selection criteria We searched for RCTs of I-C/BT compared to face-to-face or Internet-based psychological treatment, psychoeducation, wait list or care as usual. We included studies of adults (aged over 16 years or over), in which at least 70% of the participants met the diagnostic criteria for PTSD, according to the Diagnostic and Statistical Manual (DSM) or the International Classification of Diseases (ICD)

Combat-related trauma : an historical analysis through a biopsychosocial lens

The purpose of this study was to historically examine the biopsychosocial effects of combat-related trauma in veterans with the purpose of guiding treatment. The evolution of the combat-related trauma diagnosis from WWI to present conditions in Iraq and Afghanistan was examined, inclusive of etiology, symptomatology, pathology, and treatment interventions as understood through a biological, psychological and social perspective. Clinical social workers are well aware that new ideas with regards to treatment methodology do not occur in a vacuum. To be considered and accepted they must be compatible with existing ideas created through other sciences, technological advancement, economic conditions, political climate, and social milieu. This thesis examined these influences and their effect on the historical diagnosis and treatment of combat-related trauma. As the Smith College School for Social Work was founded with the purpose of treating soldiers returning from World War I who suffered from combat-neuroses, this thesis also explored the schools historical contribution to the field of clinical social work as it pertained to combat-related trauma through curriculum, theoretical perspectives, and endorsement of treatment paradigms. Finally, content reflected the diversity of soldiers who have continuously served in our armed forces and the sacrifices made by all as evidenced by the personal narratives woven throughout. Within this research several gaps and discrepancies were discovered while many insights were gained; allowing for specific treatment recommendations and relative conclusions